Knowledge, attitude and practices about dengue fever among adults living in Pwani Region, Tanzania in 2019

A Concept Analysis of Health-Seeking Behavior Toward Dengue Fever

Understanding health-seeking behavior toward dengue fever is crucial for early diagnosis and timely treatment to mitigate fatal outcomes. In this paper, a concept analysis based on Walker and Avant's method was performed to define health-seeking behaviors regarding dengue fever. This behavior was defined as a series of actions increasing awareness, promoting preventive measures, facilitating informed health decisions, and ensuring timely access to medical care. This concept analysis clarified how awareness, preventive measures, and access to care influence health-seeking behaviors. Our analysis may help refine health care taxonomies and foster a standardized language for describing health-seeking behaviors in nursing and public health contexts.

Unraveling the dynamics of dengue in Metahara town, East Shewa, Oromia, Ethiopia, 2023

BACKGROUND

Since 2013, dengue cases have shown a marked increase in Ethiopia. The current suspected outbreak occurring in Metahara town, Oromia Regional State, began in July 2023. This study aimed to confirm and characterize the outbreak, identify risk factors, and implement control measures.

METHODS

We conducted a descriptive study and an unmatched case-control design, using a one-to-two ratio of cases to controls. We collected data on the dengue outbreak using line lists, laboratory test results, environmental observations, home visits, and entomological examinations. We selected a total of 50 cases using simple random sampling from the line list and purposively chose 100 controls from the same block. We applied community-based face-to-face interviews with 150 participants. After gathering data through Kobo Collect, we analyzed it using Statistical Package for the Social Sciences (SPSS) version 26 and summarized the findings in Microsoft Excel 2013. A binary logistic regression model was employed to identify significant variables, with p-values ≤ 0.25 in bivariate analysis considered for the final model. Crude and adjusted odds ratios (OR and AOR) were used to measure associations, with p-values ≤ 0.05 indicating significance.

RESULTS

The investigation confirmed 342 dengue cases, corresponding to an attack rate of 7.1 per 1,000 population and a case fatality rate of 0.88%. Significant risk factors included not using long-lasting insecticide nets during the daytime (9-fold increased likelihood) and having open water containers (5-fold increased likelihood. Respondents lacking disease awareness were 25 times more likely to be infected, while wearing long-sleeved clothing conferred a protective effect of 75% reduction in risk.

CONCLUSION

The dengue outbreak in Metahara town was driven by epidemiological, entomological, and environmental factors, with Aedes aegypti as the primary vector. The ongoing circulation of DENV-3, coupled with insufficient vector control measures, poses a serious public health threat. Key contributing factors to the outbreak include the lack of utilization of long-lasting insecticide nets (LLINs) during the daytime, improper water storage practices, insufficient public knowledge regarding transmission and prevention strategies, and inadequate protective clothing choices that increase vulnerability to mosquito bites. Strategies including vector control, community education, promotion of protective clothing, and improved surveillance were recommended.

Risk of Aedes-borne diseases in and around the Tanzanian seaport of Tanga despite community members being more concerned about malaria

BACKGROUND

Increased global trade, while beneficial economically, can also increase the spread of vector-borne diseases, particularly those transmitted by Aedes mosquitoes spreading via trade routes. Given the heightened trade-induced activity at ports of entry, it is particularly crucial to assess the risk of mosquito-borne diseases in these settings. This study compared the risks of Aedes-borne disease in and around the eastern Tanzanian seaport of Tanga.

METHODS

A 200 m × 200 m grid-based system was used to sample mosquitoes within the port area, and in surrounding areas at 2 km, 2.5 km, and 5 km away, between June and December 2023. We characterized mosquito breeding habitats, collected mosquito larvae using standard dippers and tested susceptibility of raised adult Aedes aegypti populations to different insecticides. Adult mosquitoes were collected using BG sentinel traps (daytime) and Centers for Disease Control (CDC) light traps (night-time). Additionally, more than 200 port users and neighboring residents were surveyed to assess their experiences with and perceptions of mosquito biting and disease risks.

RESULTS

There were 2931 breeding sites, with (60.8%, n = 1782) positive for Aedes larvae. The percentage of water-holding containers infested with Aedes immatures, i.e., the container index (CI), was highest in the port area (66.2%), and lowest 5 km away (44.6%). The port area also had a greater proportion of temporary breeding sites (64.9%) than did the surrounding areas. The adult mosquito surveys revealed 20,449 mosquito species including: Culex quinquefasciatus (56.2%), Mansonia uniformis (38.6%), Ae. aegypti (5.1%), Anopheles gambiae (0.1%), and Anopheles funestus. Ae. aegypti were more abundant in the port area than in the surrounding areas (P < 0.001), whereas Culex sp., and Mansonia sp., were significantly outside (P < 0.001). Adult Anopheles sp., were found only in the port area, but Anopheles larvae were found both within and outside the port areas. Tests on Ae. aegypti sp., revealed susceptibility to bendiocarb and DDT, and resistance to permethrin. Awareness of mosquito-borne diseases among respondents was high for malaria (64.8%), but low for dengue (26.3%) and Chikungunya (1.7%). Most respondents reported being bothered by mosquitoes mostly at night (53.4%) or in the evening (40.7%). In addition to insecticidal bednets, which are used primarily against malaria, preventive measures for Aedes-borne diseases are limited.

CONCLUSIONS

This study identified significant potential risk of Aedes species, specifically Ae. aegypti sp., and associated diseases, but low perception of risk and inadequate personal protection measures in the study area. This low perception of risk highlights the need to improve public knowledge of the transmission and control of Aedes-borne diseases.

Knowledge, attitudes, and practices of health care professionals regarding dengue fever: need for training and provision of diagnostic equipment in Togo in 2022, a cross-sectional study

Background

Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and practices (KAP) of health professionals in the Kara health region.

Methods

A cross-sectional study was conducted from March to June 2022 among healthcare professionals who had worked in the Kara region of northern Togo were selected using an exhaustive recruitment method. Data were collected by trained resident doctors with a face-to-face interview using a standardized, pretested questionnaire based on the WHO 2009 dengue guide. Three multivariate regression models were utilized to investigate factors associated with knowledge, attitudes and, and practices.

Results

A total of 464 respondents (37.1% female), median age 35 years, interquartile range (29-43 years) were included. Only (3.0%) of the participants had received training on dengue fever diagnosis, treatment and prevention in the last 3 years, and 10.3% had dengue rapid diagnostic tests available at their hospital. Half of the respondents (49.1%) had good knowledge of dengue fever, compared with 30.0% who had positive attitudes. Of a total of 256 professionals who had encountered a case of dengue fever in their practice, only 24 (9.4%) had appropriate practices for diagnosing and treating dengue fever. In multivariate analysis, the healthcare professionals who had taken part in ongoing training on dengue fever were more likely to have adequate dengue diagnosis and treatment practice aOR = 8.1; CI 95% = [1.7-36.0].

Conclusion

Strengthening healthcare professionals' dengue-related skills through ongoing training and the provision of dengue diagnostic tests could help improve early detection practices and management of dengue fever in Togo.

Sociodemographic factors associated to knowledge and attitudes towards dengue prevention among the Peruvian population: findings from a national survey

OBJECTIVES

To evaluate the frequency of knowledge and attitudes towards dengue prevention among the Peruvian population, as well as the sociodemographic factors associated with reported knowledge and attitude outcomes.

DESIGN/SETTING

A cross-sectional study was conducted, based on information from the National Survey of Budget Programs of Peru, 2019.

PARTICIPANTS

We included 57 829 respondents with a mean age of 40.3±17.4 years, of whom 52.8% were women and 87.6% were from urban areas.

PRIMARY AND SECONDARY OUTCOMES

Knowledge about dengue infection (transmission, symptoms, importance of going to a health centre and not self-medicating) and preventive attitudes to avoid infection.

RESULTS

Of all the respondents, 36.2% (n=23 247) presented good knowledge about dengue and 11.6% (n=7890) had a higher number of preventive attitudes (≥3 attitudes). In the multivariate regression analysis, we found that being female (for knowledge: aPR (adjusted prevalence ratio): 1.03; 95% CI 1.02 to 1.03; and for attitude: aPR: 1.02; 95% CI 1.01 to 1.02), being married/cohabiting (for knowledge: aPR: 1.02; 95% CI 1.00 to 1.03; and for attitude: aPR: 1.01; 95% CI 1.00 to 1.02) and residing in the jungle (for knowledge: aPR: 1.14; 95% CI 1.12 to 1.16; and for attitude: aPR: 1.09; 95% CI 1.07 to 1.11) were associated with better knowledge and more preventive attitudes. In addition, we found that being an adolescent (for knowledge: aPR: 0.97; 95% CI 0.96 to 0.99; and for attitude: aPR: 0.99; 95% CI 0.97 to 0.99), and belonging to the Quechua ethnic group (for knowledge: aPR: 0.93; 95% CI 0.91 to 0.94; and for attitude: aPR: 0.98; 95% CI 0.97 to 0.99) were associated with a lower proportion of adequate knowledge and fewer preventive attitudes.

CONCLUSIONS

Our study found a high proportion of poor knowledge and few preventive attitudes towards dengue in the Peruvian population. That highlights the requirement to implement national strategies to educate people about dengue and promote preventive attitudes, considering the factors found.

Dengue Fever Outbreak Investigation in Werder Town, Dollo Zone, Somali Region, Ethiopia

Background

Dengue fever (DF) is a mosquito-borne disease caused by the dengue virus. DF is endemic to many tropical and subtropical countries around the world. In Ethiopia, DF emerged in 2013 and caused a serious public health problem.

Objective

We investigated the outbreak to describe by time, place, person, and to identify risk factors associated with the outbreak in Werder town, Dollo Zone, Somali Region, Ethiopia.

Methods

Descriptive and case-control studies (1:2 ratio) were conducted. We used the World Health Organization (WHO) case definition to identify cases in Werder town from December 10, 2020, to January 4, 2021. Controls were selected from the same town that did not suffer from DF. Serum samples were tested by reverse transcription polymerase chain reaction (RT-PCR) to detect the dengue virus and to identify serotypes. A structured questionnaire was used to collect socio-demographic, behavioural, and environmental characteristics.

Results

We identified a total of 57 cases and 114 controls. The overall attack rate was 334.41/100,000 with a zero case fatality rate. Six out of twenty serum samples tested positive for the DEN-3 serotype. In multivariate analysis, not hearing of DF (Adjusted odd ratio (AOR): 2.2, 95% CI: 1.015-4.701), not knowing the mode of transmission (AOR: 2.9, 95% CI: 1.338-6.831), not using long-lasting insecticidal net (LLITN) (AOR: 4.4, 95% CI: 1.592-12.330) and not spraying insecticide (AOR: 3.6, 95% CI: 1.591-8.098) were statistically significant risk factors associated with DF outbreak. However, wearing long sleeves (AOR: 0.435, 95% CI: 0.206-0.918) was a protective factor for the DF outbreak.

Conclusion

DF outbreak in Werder town has been confirmed. The present study provides evidence-based information regarding the identified risk factors that have contributed to the occurrence of DF outbreaks. We recommended implementing vector control measures and strengthening dengue surveillance systems is strongly advised.

Associations between Psychological Variables, Knowledge, Attitudes, Risk Perceptions and Health Behaviours towards COVID-19 among Adolescents

There is currently little scientific evidence available that allows us to understand patterns of knowledge, risk perception, attitudes, and behaviours among adolescents in relation to COVID-19. This study aims to analyse the relationship between knowledge about COVID-19, risk perception, and psychological variables and the adherence to preventive measures among the adolescent population. It is a descriptive cross-sectional study, which included adolescents between the ages of 12 and 18 (n = 354). The questionnaire was sent to several secondary schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Descriptive, univariate, and multivariate analyses were carried out in order to determine whether knowledge about COVID-19, risk perception, tolerance of frustration, planning and decision-making, family functionality, self-efficacy, self-esteem, and social skills are related to preventive measures. The adoption among adolescents of behaviours which protect them against COVID-19 depends on knowledge about the disease, the perception of the risk it poses to them, as well as their tolerance of frustration and planning and decision-making abilities. The relationship between the individual variables among adolescents with the adoption of behaviours which protect them against COVID-19 has been confirmed. The development of intervention and communication strategies that take the psychosocial situation of adolescents into account will help to increase the adoption of protective health behaviours in the context of a pandemic.

Knowledge, Attitudes, and Behavior of Larva Monitoring Interpreter (Jumantik) Cadre as Efforts to Prevent Dengue Cases

Background: Efforts to prevent and control DHF in Palu City are still inadequate. The lack of community participation in the implementation of 3M causes the density of Aedes aegypti larvae to be high. Objective: To analyze the knowledge, attitudes and behavior of larva monitoring interpreters before and after being given health education in reducing dengue cases. Methods: This type of research is a quasi-experimental, with one group pre and posttest design. Carried out in Palu City, Central Sulawesi Province and Pasang Kayu Regency, West Sulawesi Province. The sample size is 98 Jumantik cadres. The interview study instrument used a set of previously validated and tested questionnaires. Informed consent was taken from all respondents and confidentiality was guaranteed throughout the study. Data were analyzed using SPSS with Paired T-test dependent   Results: Knowledge about ways to prevent DHF increased the highest from the pre-test (20.10) post-test (51.77) which means that it increased by 32.3% p = 0.000, the smallest increase in knowledge about the spread of DHF was the pre-test value ( 12.9) post-test (14.2) means an increase of 1.3% p=0.003. The attitude that increased the most was the effort to control DHF with a pre-test value (9.4) post-test (48.2%) increased by 38.8% p = 0.000, while the smallest increase was the attitude of responsibility for controlling DHF with a pre-test value. -test (53.32) post-test (53.50) increased by 0.18% p=0.737. The behavior with the highest increase in value was about larval control with a pre-test score (4.75) post-test (37.78) means an increase of 33.0% p = 0.000, while the smallest increase is the behavior of draining the water tank with the pre-test (26.87) post-test (35.83) increasing 8.96% p = 0.002. Conclusion: Health education through counseling methods is effective in increasing the knowledge, attitudes and behavior of Jumantik Cadres in preventing dengue fever in Palu City, Central Sulawesi and Pasangkayu Regency, West Sulawesi

Uncovering the Burden of Dengue in Africa: Considerations on Magnitude, Misdiagnosis, and Ancestry

Dengue is a re-emerging neglected disease of major public health importance. This review highlights important considerations for dengue disease in Africa, including epidemiology and underestimation of disease burden in African countries, issues with malaria misdiagnosis and co-infections, and potential evidence of genetic protection from severe dengue disease in populations of African descent. The findings indicate that dengue virus prevalence in African countries and populations may be more widespread than reported data suggests, and that the Aedes mosquito vectors appear to be increasing in dissemination and number. Changes in climate, population, and plastic pollution are expected to worsen the dengue situation in Africa. Dengue misdiagnosis is also a problem in Africa, especially due to the typical non-specific clinical presentation of dengue leading to misdiagnosis as malaria. Finally, research suggests that a protective genetic component against severe dengue exists in African descent populations, but further studies should be conducted to strengthen this association in various populations, taking into consideration socioeconomic factors that may contribute to these findings. The main takeaway is that Africa should not be overlooked when it comes to dengue, and more attention and resources should be devoted to this disease in Africa.

Editor's choice: this December 2020

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